<script type="text/html" id="tpl_zhenliao">
<div class="public-tpl-row1">
    <form class="layui-form" id="tpl_zhenliao_form" action="{:url('index/dictionary.zhenliao/info')}">
        <input type="hidden" name="id" value="" autocomplete="off" class="layui-input">
        <fieldset class="layui-elem-field layui-field-title"><legend>诊疗项目信息</legend></fieldset>
        <div class="layui-form-item">
            <div class="layui-inline"><label class="layui-form-label"><i class="c-red">*</i>项目编码</label>
                <div class="layui-input-inline">
                <input type="text" name="bianma" autocomplete="off" class="layui-input">
                </div>
            </div>
            <div class="layui-inline"><label class="layui-form-label" id="tpl_zhenliao_label"><i class="c-red">*</i>项目名称</label>
                <div class="layui-input-inline">
                <input type="text" name="name" autocomplete="off" class="layui-input">
                </div>
            </div>
            <div class="layui-inline"><label class="layui-form-label">项目单位</label>
                <div class="layui-input-inline">
                    <select name="ls_unit">
                        {volist name="zlxm_unit_list" id="unit"}
                            <option value="{$unit.id}">{$unit.name}</option>
                        {/volist}
                    </select>
                </div>
            </div>
        </div>
        <div class="layui-form-item">
            <div class="layui-inline"><label class="layui-form-label"><i class="c-red">*</i>项目单价</label>
                <div class="layui-input-inline">
                <input type="text" name="price" autocomplete="off" class="layui-input">
                </div>
            </div>
            <div class="layui-inline"><label class="layui-form-label">最高限价</label>
                <div class="layui-input-inline">
                <input type="text" name="max_price" autocomplete="off" class="layui-input">
                </div>
            </div>
            <div class="layui-inline"><label class="layui-form-label">项目分类</label>
                <div class="layui-input-inline">
                    <select name="cate_id" lay-search>
                        {volist name="zlxm_cate_list" id="cate"}
                            <option value="{$cate.id}">{$cate.name}</option>
                        {/volist}
                    </select>
                </div>
            </div>
        </div>
        <div class="layui-form-item">
            <div class="layui-inline"><label class="layui-form-label">拼音简码</label>
                <div class="layui-input-inline">
                <input type="text" name="py_code" autocomplete="off" class="layui-input">
                </div>
            </div>
            <div class="layui-inline"><label class="layui-form-label">五笔简码</label>
                <div class="layui-input-inline">
                <input type="text" name="wb_code" autocomplete="off" class="layui-input">
                </div>
            </div>
            <div class="layui-inline"><label class="layui-form-label">备注</label>
                <div class="layui-input-inline">
                <input type="text" name="remarks" autocomplete="off" class="layui-input">
                </div>
            </div>
        </div>
        <div class="layui-form-item drugs_guige">
            <div class="layui-inline"><label class="layui-form-label">项目提成</label>
                <div class="layui-input-inline" style="width:100px;">
                    <select name="xm_tc_mode" lay-filter="xm_tc_mode">
                        <option value="0">无提成</option>
                        <option value="1">按提成比例</option>
                        <option value="2">按固定金额</option>
                    </select>
                </div>
            </div>
            <div class="layui-inline">
                <div class="layui-input-inline" style="width:50px;">
                    <input type="text" name="xm_tc_val" autocomplete="off" class="layui-input">
                </div>
            </div>
            <label id="zhenliao_form_tc_unit">%</label>
            <div class="layui-inline"><label class="layui-form-label">门诊特检</label>
                <div class="layui-input-inline">
                <input type="radio" name="is_mz_tj" value="1" title="是">
                <input type="radio" name="is_mz_tj" value="0" title="否" checked>
                </div>
            </div>
            <div class="layui-inline"><label class="layui-form-label">启用标志</label>
                <div class="layui-input-inline">
                <input type="radio" name="status" value="1" title="已启用" checked>
                <input type="radio" name="status" value="0" title="已停用">
                </div>
            </div>
        </div>
    </form>
</div>
</script>